Testicular Cancer Awareness Month: 9 Things to Know About Testicular Cancer

March is Testicular Cancer Awareness Month, and MUSC Health urological surgeon Dr. Gregory Diorio wants you to know that when it comes to getting screened for testicular cancer, there's nothing to be ashamed of. "A lot of times we see individuals who are ashamed, and so they ignore a strange lump in their scrotum," he says. "They're somewhat embarrassed to go get it examined."

The key to the management and prognosis of testicular cancer is early detection, Diorio says, emphasizing that self-exams are the most accessible way to do this. “And if there is any abnormality, get seen as soon as possible to get evaluated," he adds. "Don't wait."

So, what is exactly is testicular cancer?

"Testicular cancer is a tumor that arises from the cells that are contained within the testicle itself and can come from both the cells that produce the sperm as well as the cells that produce the hormones," says Diorio, who's also an assistant professor in urologic oncology and minimally invasive surgery at MUSC. "It's a tumor that derives specifically from what we call germ cell tumors that live within the testicles. Then we have what we call non-germ cell tumors as well."

Risk factors of testicular cancer

One of the biggest risk factors is a strong family history of testicular cancer. "An undescended testicle as a child can also increase your risk of developing cancer as an older adult due to the changes in the way the testicle develops as you age," he says.

Early warning signs of testicular cancer

Most testicular cancers present as a palpable mass within the testicle itself. Though not always painful, it can be associated with pain, discomfort, and/or swelling of the testicle. But most testicular cancers are found incidentally either through self-exam or by a partner.

He also encourages regular annual visits to a primary care physician. "Having a primary care physician to talk to is so important, and routine screenings can detect cancer in otherwise healthy individuals."

Is testicular cancer fatal, and how can you live with testicular cancer?

More than 95 percent of individuals who are diagnosed with testicular cancer have a five-year cancer-free survival rate. "Even if it presents in advanced stages, the survival is good and patients respond very well to treatments," Diorio says.

Most individuals will be cured with local treatment, by removing the testicle itself, and will not need chemotherapy, radiation treatment, or further surgery.

Who should get screened for testicular cancer

Testicular cancer is a very rare cancer, accounting for only one percent of all male cancers. Still, it's the most common solid tumor cancer seen in young men, specifically between the ages of 20 and 35.

How to screen for testicular cancer

"The screening that we do recommend is routine self-exams, at least monthly, which involves a palpable self-exam of both testicles," Diorio says. "And for men, we usually recommend that you do it when you're bathing to feel for any hardness, any firmness, any change in size, tenderness, or anything that you feel is abnormal."

So you find a testicle abnormality: What's next?

After discovering an abnormality, patients should seek evaluation immediately.

If diagnosed, you'll undergo an ultrasound of the scrotum and both testicles, which will define the size, shape, and location of the testicular mass.

Blood tests — or tumor markers HCG, FP, and LDH — can be ordered to determine the specific tumor types found. "We can also use those after treatment to monitor treatment response," Diorio says.

As long as the particular cancer is contained within the testicle, the next step is to perform what's called a radical orchiectomy, which is the removal of the entire testicle and the spermatic cord — the structure that the testicle hangs from.

What to expect from testicular cancer treatment

Testicular cancer treatment is a routine outpatient procedure. "We make a small incision through the lower groin to remove the testicle up through the scrotum into that groin incision, and then remove the testicle that way," Diorio says. "Some men request, and we do offer, replacement of the testicle with a testicular prosthesis, which is done at the same time."

How testicular cancer affects fertility

If patients are interested in potentially preserving all fertility, MUSC Health offers sperm banking. Any patients at risk for infertility — be it from a contralateral testicle, an atrophic testicle, or an absent other-testicle — are counseled accordingly.

Call 843-792-9300 to schedule an appointment with a specialist at MUSC Hollings Cancer Center.